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James Ironside

James IronsideProfessor of Neuropathology, Edinburgh University

Interview location: His office at the Western General Hospital, Edinburgh
Interview date
: 3rd September, 2007

Key ThemesAlder Hey, Attributes of a Pathologist, Autopsy,  Legislation and RegulationMentors and Influences, Research versus Clinical Work



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It's very important that we as pathologists remember that diagnosis is not made in a vacuum, or it's not something that exists only between you and the clinician. There's much wider impact, not just for the patient, but for the whole family

James Ironside carried out the autopsies on some of the first victims of 'new variant' CJD associated with mad cow disease in the early 90s, and was the first to draw attention to the extraordinary pathology he found in their brains. “The pathology was very different from any case of sporadic CJD that we had seen, or that had ever been reported. That was the time I really thought we had something new.”  But collecting the hard evidence to support this view was a painstaking job of detective work on a global scale, which culminated in a successful presentation to the World Health Organization. 

Ironside is a member of the national CJD Surveillance Unit set up to monitor the long-term consequences of the epidemic of mad cow disease in the UK.  He is today recognised worldwide as an expert in CJD and other spongiform encephalopathies – brain diseases believed to be caused by a rogue version of one of the body's own proteins, called a prion. 

Huge questions remain about prion diseases: are there still people incubating CJD from eating contaminated beef perhaps 20 years ago?  Who else might be at risk of the diseases today, and from what sources?  Even the 'prion hypothesis' remains controversial, says Ironside.

Alongside his clinical and research work, he plays a significant role in the Human Tissue Authority.  His work on prion diseases has convinced him of the crucial importance of maintaining tissue and organ archives, and he is concerned about the implications for such research of recent legislation. “My main motivation for joining the Authority was to try and make the implementation of the [Human Tissue] legislation as good as it could be for both the profession and the public.”


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